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General NPI Number Information
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NPI Number | 1972804912
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Entity Type | Organization
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Legal Business Name | JAYESH KAMDAR, MD
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Dates
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Enumeration Date | 11/08/2010
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Last Update Date | 11/29/2010
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Provider Practice Location Address
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Address Line | 99-78 65TH ROAD GROUND FLOOR
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City | REGO PARK
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State | NY
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Zip | 11374
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Country | US
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Telephone | 718-685-2908
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Fax | 718-685-2991
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Provider Business Mailing Address
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Address Line | 9978 65TH RD GROUND FLOOR
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City | REGO PARK
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State | NY
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Zip | 11374-3655
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Country | US
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Telephone | 718-685-2908
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Fax | 718-685-2991
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Authorized Official
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Title or Position | NEUROLOGIST/PRACTICE OWNER
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Name | DR. JAYESH C KAMDAR
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Credential | M.D.
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Telephone | 718-695-2908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 164457
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License Number State | NY
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